This grant will supplement epidemiology and laboratory capacity within the Tennessee Department of Health Emerging Infections Program (EIP) to help meet several critical public health needs. We are requesting a new Public Health Administrator 2 to function as a senior administrative manager for all EIP activities. This person will have responsibility for oversight of grant management, fiscal reporting, personnel and administrative coordination among all EIP programs and studies. We will hire a new epidemiologist who will have responsibility for coordination of data management activities across EIP programs and sites, as well as coordination with CDC regarding interoperability issues. They will be responsible for ensuring that EIP is appropriately represented and integrated in state-level efforts to improve electronic laboratory reporting and hospital communicable disease reporting in the context of national eHealth initiatives. Funding is requested to support quarterly webinars for surveillance staff and health department epidemiologists statewide on EIP-related topics. We will offer training on the use of NHSN to infection prevention staff at all Tennessee hospitals. In addition to these core capacity-building efforts, Tennessee will continue to actively participate in EIP Influenza projects, and launch a new program for surveillance of bloodstream infections in dialysis patients (DA-BSI). For influenza activities, two additional surveillance officers (one full-time, one part-time) will expand outreach with specific attention to obtaining specimens from catchment hospitals for rRT-PCR diagnosis. The overall objective of the DA-BSI study is to develop sustainable methodology for surveillance and to describe the epidemiology of DA-BSI. Standardized reporting and knowledge of DA-BSI epidemiology will allow for the development and evaluation of interventions to prevent them. We will hire a nurse who will actively participate in protocol development with CDC, and travel to dialysis centers participating in the validation study for on- site chart reviews.